Medical Retinal Conditions FAQs
The information below relates to some of the more common conditions that are managed in Medical Retina clinics at Moorfields. If you need to speak to a clinician urgently, you can email: firstname.lastname@example.org (please provide your name and hospital number), or call us on 0207 566 2472.
We understand that many of our patients will be feeling anxious about having their appointments postponed during the current coronavirus situation. If your appointment has been postponed in the current coronavirus COVID-19 pandemic, this will usually be after your clinical team has been through your records, and has felt that the risk of harm to your sight from your appointment being postponed is likely to be lower than the risk of harm to you or others from you attending your scheduled appointment. However, our advice, as always, is that if you have noticed an abrupt change in the vision of either eye, you should contact our nurse-led line for advice on , or contact 111 online. We continue to provide emergency eye care services at City Road and other sites. Further information on urgent eye care can be found on our website in the Coronavirus section.
The information below is for the more common medical retina conditions. (It does not cover conditions treated in other clinics, such as oncology, uveitis or vitreoretinal surgical diseases).
List of conditions
- Age-related macular degeneration (AMD)
- Diabetic eye disease
- Retinal vein occlusions
- Genetic retinal diseases (including retinitis pigmentosa)
- Central serous chorioretinopathy
- Hydroxychloroquine retinal monitoring
- Retinal macroaneurysm
- Coats’ disease or type 1 juxtafoveal telangiectasia
- Sickle cell disease affecting the retina
Age-related macular degeneration (AMD)
I am receiving injections into my eye for wet age-related macular degeneration
Most patients who are receiving injections into their eyes for wet AMD need these injections to preserve their vision and prevent it getting worse. The clinical team are prioritising these patients and patients will continue to receive these injections where possible. During their visit, patients might undergo fewer examinations than usual to reduce the time they spend in the hospital.
I am being monitored for age-related macular degeneration, but am not currently receiving injections
Most patients with AMD who are not currently receiving injections are likely to be quite stable. It is possible therefore that your appointment is postponed in the current situation. As with our usual advice, you should seek attention should you notice an abrupt change in the vision of either eye (such as new distortion in your vision).
Diabetic eye disease
Diabetes can affect the eye, and an important way of preventing sight loss is keeping your blood sugar under control (as well as keeping blood pressure under control for patients with high blood pressure). Thus you should continue with your usual medication as advised by your GP or diabetes specialist.
In medical retina clinics, diabetic eye disease is sometimes treated by injections into the eye or by retinal laser treatment (and sometimes by a combination of both treatments). Some of these treatments can be urgent, and others are not so urgent.
I have proliferative diabetic retinopathy
Proliferative diabetic retinopathy refers to the condition where new blood vessels have grown, usually on the retina (the layer at the back of the eye that detects light). These new blood vessels can bleed or cause scarring, which can cause loss of vision. It is usually treated with retinal laser treatment over a number of sessions (called panretinal photocoagulation). If patients have proliferative diabetic retinopathy with certain high risk features, they need urgent retinal laser treatment within a few weeks. If you fall in this category, then your appointment will not be postponed.
However, if you have already had adequate treatment in the past for proliferative retinopathy, and your clinical team now considers your disease is stable, or if you do not have proliferative retinopathy, your appointment might be postponed in the current situation.
I have diabetic macular oedema
Diabetic macular oedema refers to fluid building up in the central part of the retina. This sometimes gets better by itself and sometimes can be treated with retinal laser or injections into the eye. This condition tends to change slowly, so it is possible that your appointment will be postponed. Often, even if the injections are delayed for a number of months, the injections can still work when they are re-started to improve or preserve the vision.
Retinal vein occlusions
If you have suffered a retinal vein occlusion (which can be a central retinal vein occlusion or branch retinal vein occlusion or hemiretinal vein occlusion), you might be being monitored in the medical retina clinic for a number of reasons. Most of these are not urgent situations except for a condition called rubeosis.
I have been diagnosed with rubeosis iridis (iris new vessels)
This condition involves new blood vessels growing over the coloured part of the eye (the iris). This can block fluid draining out of the eye and make the pressure in the eye become very high leading to pain and loss of vision. This can happen after some types of central retinal vein occlusion. It is a condition that usually requires urgent retinal laser and sometimes and injection into the eye or other treatments. Patients who are diagnosed with this condition or who are felt to be at high risk of this condition will not have their appointments postponed.
If you have been diagnosed with a retinal vein occlusion, and your vision suddenly gets a lot worse or your eye becomes painful, you should seek attention (even if your appointment had been postponed).
I have been diagnosed with macular oedema caused by a retinal vein occlusion
Macular oedema (fluid building up in the central part of the retina) can occur after a retinal vein occlusion. In some cases, it gets better itself, and in other cases, it can be improved with treatments, most commonly injections into the eye. These injections are not usually urgent and can be postponed in some cases. Even after postponing for several months, the oedema can improve once the injections have been re-started.
Genetic diseases of the retina
Genetic diseases of the retina are those in which a spelling mistake in one of your genes has led to a problem with the retina. There are many different terms used for different genetic retinal diseases including the following: retinal dystrophy, macular dystrophy, retinitis pigmentosa, rod-cone dystrophy, Stargardt disease, cone dystrophy, cone-rod dystrophy, X-linked retinoschisis, dominant drusen, achromatopsia, Best disease, Leber congenital amaurosis. Sometimes the disease is referred to by the associated gene, such as ABCA4 retinopathy or KCNV2 retinopathy. Unfortunately most of these diseases do not currently have medical or surgical treatments at present. Treatment is mainly supportive (for example with magnifiers provided by the low vision clinic and registration as sight impaired). Thus in the majority of cases, appointment are being postponed in the current situation.
A few of these conditions can be associated occasionally, or rarely, with the development of leaky new blood vessels under the centre of the retina (a bit like wet AMD) and these might benefit from prompt injections into the eye, so you are advised to seek attention if there is a sudden drop in vision or new permanent distortion in the vision of either eye.
I am receiving drops or tablets for cystoid macular oedema associated with my genetic retinal disease
Some genetic retinal diseases are associated with fluid building up in the central part of the retina (called cystoid macular oedema) or with splitting of the central retina (as in X-linked retinoschisis). In some cases, this responds to drops (such as dorzolamide or brinzolamide) and some patients have been prescribed tablets (acetazolamide tablets, also known as Diamox). This condition tends to change slowly and so your appointment might have been postponed. If so, you can continue your current treatment, but do not be anxious if you have a break in treatment (even for some months) as we do not think that a break in treatment in itself is likely to cause irreversible damage. If you are taking Diamox tablets, we suggest having your kidney function tested by a blood test at your GP approximately every 6 months.
I want to know the results of my genetic testing
Many of our patients have undergone genetic testing and were expecting to discuss the results of their genetic tests at their appointment. We will write to you with the results of your genetic tests when these are available and our team of genetic counsellors also very happy to discuss your results with you over the phone.
I have heard about gene-therapy treatments being given and do not want to miss out on these
There is only one gene-therapy treatment for a genetic retinal disease that is currently licensed.This is called Luxturna and is for a very rare cause of genetic retinal disease associated with spelling mistakes in both copies of a gene called RPE65. The vast majority of genetic retinal disease patients do not have problems in this gene, and so will not benefit from this treatment. In any case, at present, these treatments are on hold due to the risks in the current situation.
Other experimental treatments for different genetic diseases are being trialled at Moorfields and elsewhere. However, these experimental treatments are not yet proven to be safe and effective, and are on hold in any case due to the current coronavirus situation.
Central serous chorioretinopathy (CSCR or CSR)
In this condition, fluid builds up under the retina due to an abnormality in the layer underneath the retina. In some patients it is associated with steroid exposure. This condition tends to change very slowly, and in many cases, can improve without any treatment. Thus, in the current situation, your appointment is likely to be postponed. However, if you notice a sudden change in vision, we advise you to seek attention.
Hydroxychloroquine retinal monitoring
Some patients who are taking a drug called hydroxychloroquine (Plaquenil) prescribed by physicians for a number of autoimmune conditions including lupus might have been expecting an appointment for monitoring of retinal side effects. Patients who are taking high doses, or have been taking the drug for more than 5 years, or who have some other risk factors (including kidney problems or tamoxifen treatment) are at higher risk of damage to the retina. The condition changes very slowly, and so patients who have their appointments postponed by some months in the current situation are unlikely to come to significant harm.
In this condition, there is an abnormality in a blood vessel in the retina that can cause bleeding or leakage of fluid. It usually only affects the vision if the leakage or bleeding affects the centre of the retina. It can be associated with high blood pressure. In some cases, the condition can improve itself, but in other cases, treatments including retinal laser or injections into the eye are considered. In most cases, this is not an urgent condition, and appointments might be postponed for some months in the current situation. However, if you feel your vision is deteriorating or have noticed a sudden change, you should seek attention.
Coats’ disease or type 1 juxtafoveal telangiectasia
These are conditions in which abnormal vessels, usually just in one eye, can leak, usually affecting males. (Coats’ disease is a more widespread form, affecting more of the retina). Vision is usually only affected if the centre of the retina is affected or obscured. In some cases, the condition can improve itself or remain stable, but in other cases, treatments including retinal laser or injections into the eye are considered. In most cases, this is not an urgent condition, and appointments might be postponed for some months in the current situation. However, if you feel your vision is deteriorating or have noticed a sudden change, you should seek attention.
Sickle cell disease affecting the retina
Patients with sickle cell disease (HbSS or HbSC) can have abnormalities develop in the retina, including areas of retinal thinning and areas where new blood vessels develop. In most cases, these do not need specific treatment, and patients are usually monitored annually. Your appointment might be postponed in the current situation, and this is unlikely to lead to any problems. Again, if you have a sudden change in vision you should seek attention.
This is a rare condition in which there are specific abnormalities in the centre of the retina usually in both eyes. There is no treatment at present, but patients are sometimes monitored annually. Your appointment might be postponed in the current situation, and this is unlikely to lead to any problems, but if you have a sudden change in vision you should seek attention (as this can indicate a cause of vision loss that might potentially benefit from a treatment).